What question did this study set out to answer?

Review the development of the GRACE risk-prediction model and evaluate how observational registry evidence shapes clinical practice guidelines for acute coronary syndrome.

July 1, 2015European Heart Journal SupplementsOpen Access

The GRACE registry: how real-life evidence contributes to acute coronary syndrome guidelines

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Review the development of the GRACE risk-prediction model and evaluate how observational registry evidence shapes clinical practice guidelines for acute coronary syndrome.
Multicenter multinational registry enrolling patients across >240 hospitals in 30 countries throughout Europe, the Americas, Asia, and Australasia.
Eligible patients were adults (≥18 years) with presumptive acute coronary syndrome, clinical history, and confirmatory electrocardiographic abnormalities, elevated cardiac necrosis biomarkers, or documented coronary disease.
Applied Cox proportional hazards models on eight clinical variables—including age, systolic blood pressure, Killip class, serum creatinine, and ST deviation—to predict cumulative mortality up to 5 years.
Cox proportional hazards analysis demonstrated significantly elevated 5-year mortality in intermediate-risk (HR 2.14, 95% CI 1.63–2.81) and high-risk strata (HR 6.36, 95% CI 4.95–8.16) compared to low-risk patients (Wald 709.9, P < 0.0001).
Risk stratification effectively identified therapeutic response thresholds, where patients with a score >140 derived clear clinical benefit from early invasive revascularization strategies.

Structured PICO

Population

Patients with acute coronary syndrome (ACS) enrolled in the GRACE registry (≥18 years old with presumptive diagnosis of ACS and clinical history of ACS plus ECG changes, biomarker increases, or documented CAD)

Intervention

Risk stratification using the GRACE risk score

The GRACE risk score provides robust, validated risk stratification for patients with acute coronary syndrome, guiding treatment decisions in accordance with major clinical guidelines.

Discussion

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Implication

May support long-term ACS prognostication; leaves open whether GRACE-guided therapy improves outcomes.

Cite This Study

Freek W.A. Verheugt (2015) studied this question.

synapsesocial.com/papers/6a8a4844abe412682d931e9e https://doi.org/10.1093/eurheartj/suv039

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The GRACE registry: how real-life evidence contributes to acute coronary syndrome guidelines

Key Points

Structured PICO

Discussion

Implication

Cite This Study

The GRACE registry: how real-life evidence contributes to acute coronary syndrome guidelines

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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